I'm 37 years old in a few days, I've had this lump almost at the top of my spine at base of neck for a couple months now, its about the size of a canadian loonie, and it is not extremely painful, but there is a dull ache every now & then and if I tilt my head or strech my arms to reach for anything, or even if I shrug my shoulders, the ache comes back, the ache does not last long, but it lets me know it's there. Any ideas as to what this could be? I do not have a doctor and there is a 5 year wait list here. we have one walk in clinic and it's at the hospital. I don't want to waste anyones time if it's nothing to worry about.

Hello,Diagnosis of any swelling mandates direct clinical examination. Diagnosis of any lump would be easier when associated symptoms and signs are present. This includes mobility, tenderness, pain, consistency (soft, firm or hard) and any systemic symptoms like fever and weight loss.

However, at this site it could be an enlarged lymph node (posterior cervical group). If infection or inflammation occurs in the area drained by these nodes, they grow in size and become painful. When infection or inflammation subsides they regress in size but never disappear. This group of lymph nodes drains the ear, scalp and the skin of the upper back and the posterior part of the neck.

So, these nodes remain palpable, painless, rubbery in consistency and usually less than 1 cm in diameter. They may be painful when you frequently press causing a sort of inflammation. Other causes of lymph node enlargement include systemic diseases and cancer.

Other causes include:A folliculitis which is inflammation of the hair follicle forming a swelling that is soft to firm, painful or tender, warm and may decline in size or disappear after recovery from the infection.

Lipoma, a benign tumour of the fat cell that is felt soft mobile and not painful or tender unless inflamed.

I would advise you to follow up with your doctor. Direct clinical examination and a thorough history are essential.Please keep us updated.Best regards.